Chloride is one of the most important electrolytes in the blood serum along with sodium, potassium, and calcium. Chloride is the negatively charged part of a compound possessing chlorine as an electrolyte like sodium chloride or calcium chloride. The negatively charged electrolyte is also called anion. The human body gets chloride from the daily intake of foods, and it helps to keep acid-base balance in the body. Normal level of chlorine in the human body ranges from 97-107 mEq/L. Hyperchloremia is a condition in the body, when the volume of chlorine ion elevates remarkably causing some other physical disorders, including decreased volume of oxygen content in the blood.
Symptoms of Hyperchloremia
Generally, hyperchloremia doesn’t bring forth any remarkable symptoms, until it is associated with some other physical problems like hyperglycemia, or any existing problems related to kidney. However, the symptoms of hyperchloremia may be visible, when the problem persists for a long time and remain untreated, or the chlorine ion level elevates drastically within a short period of time.
The chlorine level in the blood is mainly controlled by the kidneys. So, when the chloride level increases in the blood, there may be any undetected problem in the kidneys. Otherwise, if the chloride level is increasing for some other problem, the kidneys will try to excrete it systematically, which may cause undue load on the kidneys.
Here are some common symptoms of hyperchloremia:
- Loss of fluid leading to dehydration
- Diarrhea and vomiting
- Breathing problem including deep and rapid breathing or Tachypnea
- Kussmaul breathing (deep and hard breathing)
- Reduced cognitive functioning
- Intense thirst
- Pitting edema in different parts of the body
- Fever and sweating.
In an extreme situation, if the increasing level of chlorine is not checked in time, the problem may lead to cerebral edema.
Causes of Hyperchloremia
Following are the most obvious causes of hyperchloremia:
- Diarrhea
- Administration of excess of IV normal saline
- Kidney dysfunction, including type 1 and type 2 renal tubular acidosis
- Diabetes insipidus
- Over secretion from parathyroid glands- Hyperparathyroidism
- Metabolic acidosis
- Decreased pancreatic secretion
- Hyponatremia – a condition where the serum sodium level in the body decreases
- Side effects of some medicines like diuretics, androgens, corticosteroids, etc.
- Polypharmacy.
Diagnosis of Hyperchloremia
If the serum chloride levels go above 107mEq/L, doctors declare the condition as hyperchloremia. Following are the other major indications of the presence of hyperchloremia in the body:
- Serum carbon dioxide level falls below 22 mEq/L
- The serum pH level goes below 7.35
Apart from diagnosing the problem of hyperchloremia through various serum tests, doctors may also undertake some other diagnostic methods to detect the presence of any other problem, especially the symptoms as mentioned above, like problems in the kidneys, renal failure, gastrointestinal diseases, or endocrine disorders, etc.
Treatment of Hyperchloremia
Primarily a physician will try to normalize the levels of chloride in the body. So, the treatment procedure will be taken to correct the inherent problem or causes of hyperchloremia. Following treatment procedure are normally undertaken for hyperchloremia:
- Treatment for diarrhea is undertaken.
- If the problem of hyperchloremia is caused due to any drug as mentioned above, doctor may alter the drug.
- Intravenous infusion of sodium bicarbonate to elevate the level of bicarbonate and more renal excretion of chlorine ions.
If any other problem in some other part of the body is detected, the physician will refer the matter to the respective specialists, like nephrologist, gastroenterologist, diabetologist, etc.
Prevention of Hyperchloremia
Through some easy-to-follow methods, hyperchloremia can be prevented to a large extent:
- Normal foods that a person takes daily needs to be rich in magnesium and potassium.
- Some foods like lettuce, tomato, and celery are high in chloride. These food items are to be avoided.
- Drinking plenty of water is also necessary.
- Caffeinated products are to be avoided as much as possible.
- Intake of alcohol is to be reduced or to be completely avoided.
- Steroid related medications or drugs should be taken only on doctor’s advice.
- In case of diabetes, liver disorder, or kidney disorder, treatment should be started immediately.
Conclusion
The normal levels of chloride may increase due to many reasons. Once it starts increasing, many associated abnormalities may surface one after another. In such conditions, it is necessary to check the problem immediately through proper treatment procedure. In several other conditions, like renal failure, diabetes insipidus and edematous states etc., the normal levels of chloride may increase causing hyperglycemia, breathing trouble, and even cognitive dysfunction. While treating hyperchloremia, a physician not only provides remedies for leveling the chloride in the serum, but also tries to find out and treat the root cause of the problem.